Hotspot Kitzbühel

Tyrol has a shortage of 53 dentists for practice positions

Something is brewing! There is a huge gap in dental care for the general population in Tyrol, particularly around the upmarket town of Kitzbühel. The example of Kitzbühel shows how a healthcare system can collapse. 

There has been much discussion about the shortage of GPs in recent years. Paul Hougnon, President of the Tyrolean Dental Association, believes that another focal point has been overlooked. Because the situation is also getting worse in his field. At least in Tyrol.

There are currently 53 vacancies (54 according to the ÖGK) in dentistry in Tyrol. "There are only a few applicants," says Hougnon. In the lowlands in particular, it is hardly possible to fill vacancies in some places. Hougnon cites Kitzbühel as a glaring example. There are a few dentists there, but only on an elective basis. For patients, this means higher costs and modest reimbursement by the Austrian Health Insurance Fund (ÖGK).

My husband is an elective doctor, I am a statutory health insurance doctor. I see the difference every day in our family. I have to work significantly more for the same income.

Ingrid Schilcher, Vize-Präsidentin Tiroler Zahnärztekammer

Bild: Christof Birbaumer

"600,000 euros for a new surgery"
For Hougnon and his Vice-President Ingrid Schilcher, the reasons for the lack of panel doctors are obvious. Too little fee coverage by the health insurance fund for comparatively many complex treatments, too many additional tasks such as weekend services and extremely high costs for opening a new practice. Schilcher speaks of around 600,000 euros in investments. In a town with record real estate prices like Kitzbühel, it is of course particularly difficult, adds Hougnon.

Domino effect led to misery in Kitzbühel
Arno Melitopulos-Daum, Head of Division at ÖGK, also sees the high costs in Kitzbühel as one reason for the misery, but: "The main cause is the fact that numerous dentists in the Kitzbühel and Kufstein area retired a few years ago and the pressure on the remaining ones became too great." This has led to further redundancies due to overwork.

High rents and a lot of competition from elective dentists are a problem in the lowlands. However, the main causes were retirements and a number of redundancies.

Arno Melitopulos-Daum, Bereichsleiter ÖGK

ÖGK is currently setting up an outpatient dental clinic in Kitzbühel to close the ever-increasing gap. It is hoped that it will be able to open this year. But that is not certain. There are construction delays.

Dental outpatient clinics to fill the biggest gaps
There are already four ÖGK dental outpatient clinics in Tyrol (Innsbruck, Reutte, Wörgl, Schwaz). Without them, the system would probably already have collapsed. They take care of those who are not wanted by the private healthcare market: people with low incomes and many dental problems. Panel doctors also look after these people. "But the fees in this area are very modest," says Hougnon. As an example, he cites 23.30 euros for the extraction of a tooth, "including anesthesia and injections." By way of comparison, the recommended private tariff for anesthesia alone is currently €29, according to the Chamber.

The situation is likely to get worse. This is because fewer dentists will be coming out of universities in Austria in the next few years because the quota has fallen there.

Paul Hougnon, Präsident der Tiroler Zahnärztekammer

Bild: Christof Birbaumer

The example of dentists clearly illustrates the tension in which public healthcare is increasingly operating: Those who can afford it go to an elective doctor. At the same time, statutory health insurance doctors lack a healthy mix of patients to offset their costs.

There are ongoing negotiations on fees, says ÖGK representative Melitopulos-Daum. Recently, there have been significant increases for on-call services. The ÖGK man does not see the fees as "the" stumbling block. After all, there are no problems finding panel doctors in many regions of Austria.